PERFORMANCE APPRAISAL FORM II (A)

For Head Clerks/Junior Superintendents and other Non-Gazetted Ministerial Staff

(Non-Secretariat Service)

APPRAISAL OF

Department: Sri/Smt… . . . . . . . . . . . . . . . . . . . . . . . . . . . (in block letters)

for the period . . . . . .. . . . . . . . . . . . . . . .. . . .. . .. . . . . .. . . . .

Name :

Date of birth :

Date of appointment in Government Service :

Date of appointment to the present post :

Date of entry in the present Office/Department :

Pay and Scale of Pay :

Date from which functioning in the present grade

continuously :

List of subjects dealt with according to the office

Order distributing work :

EDUCATIONAL AND OTHER QUALIFICATIONS

General Departmental Special Other skills if any
1.

2.

3.

EXPERIENCE
Period
Department * Category of work
From To

* Category of work may be any of the following items: Establishment, Accounts, Cash, Stores,
Records Planning, Office Section and Miscellaneous.
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SELF ASSESSMENT

(To be obtained from the reportee in a separate sheet and filed as part of the facing sheet of the form)

Instructions to Reporting Officers

1. Consider only one factor at a time.

2. Study each factor and the specifications for each grade.
3. Review upon completion to see that the rating of each factor applied exclusively to the
individual’s actual performance on his present job.
4. Comment fully at the bottom of the page and on reverse side upon any matter which in your
opinion needs explanation.
5. Put a tick mark () in the appropriate boxes provided hereunder.

Section A

ASSESSMENT BY THE REPORTING OFFICER

Sl.
Factors A B C D
No
Extraordinarily Quite able to Normally Poor
Intelligence proficient and handle new and understands new comprehension,
resourceful and difficult matters situation after fails to perform a
understands new and proper function despite
1 difficult matters explanations and prior instructions
handles it if given
all directions

Exemplary conduct Observes the Tries to follow the Indifferent to the

Discipline code of conduct general code of general code of
2 conduct conduct

Punctuality and Exceptionally Always punctual Usually punctual Not punctual and
promptness punctual and prompt and prompt and prompt prompt
Exactness in keeping
time in attending office,
3 keeping appointment,
discharge of official
duties and observance of
time limits as per
manuals standing orders
Responsibility and Very conscientious Conscientious Carries out his Often fails to
Dependability and dependable in and steady responsibility in a perform his/her
the performance of worker; has a routine manner duty shirks
Conscientiousness his/her job. Always good record of responsibility
4
towards duty ready to take dependability
responsibility

Interest in the Has initiative and Takes adequate Does his/her work Indifferent in the
Assignment takes keen interest interest in a routine way discharge of his/her
duties
5
Interest and the capacity
to see that the work is
done
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Job knowledge Has an unusually Knows his/her Possess just Knowledge

thorough and job thoroughly adequate inadequate. Has
Technical and general comprehensive knowledge not yet gained
knowledge about the job mastery of his/her required for the job competence
he/she is doing field of work.
6 (a) General (of this and Strives to expand
related subject or his/her frontier of
versatality) knowledge
(b) of work
(c) up-to-dateness

Noting, Drafting and Very precise in Precise in noting Ordinary at noting Poor in noting and
Correspondence noting and drafting. and drafting. and drafting. drafting. Careless
Very prompt and Good at His/her drafts need in handling
Ability to prepare notes, accurate at correspondence. editing. Tries to correspondence.
drafts and handle correspondence. His/her drafts handle
correspondence with His/Her drafts need seldom require correspondence in
7
special reference to no editing editing. time if properly
(1) Accuracy supervised.
(2) Thoroughness
(3) Power of analysis
(4) Power of expression

Maintenance of Very neat and Keeps registers Tries to maintain Does not maintain
Registers and Records meticulous in the and records clean registers and registers and
maintenance of and up-to-date records in a routine records properly
8 Ability in maintaining
registers and records manner
register and records
keeping

Consistently exceeds Frequently Meets Consistently below

Work Turnover requirements exceeds requirements requirements
9 requirements

Extremely proficient Possess very high Always possesses Very poor in

Supervision and in supervision and ability in the ability to supervisory control
Control control supervision supervise
10
(Ability to supervision
and control)

11. Punishments awarded to the Officer if any

(Attach copies of the orders of punishments also)
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GENERAL

1. Do you know of any physical disability or health Yes ( ) No ( )

problem which prevents this Officer from working
to full capacity ?

If yes, please explain the nature of this problem

2. General garding:

(1) No. of items in Grade A

(2) No. of items in Grade B
(3) No. of items in Grade C
(4) No. of items in Grade D

Comment with special reference to:

1. The adverse remarks passed against the employee

within the course of his performance or the disciplinary
action taken against him during the period under report.

2. The effort made to improve the functioning of the

employee where his performance with reference to the
factors enumerated in this report is considered not upto
the mark or poor

3. The important requirements or factors which affect the

effectiveness of the work of the officer such as special
difficulties or handicaps, amount of direct or indirect
supervision, the emergency demands, if any, etc. and

4. Specific instances of any work worthy of being mentioned

in support of the assessment in the graphic section.
(Add separate sheets if necessary)

Signature of Reporting Officer

Date of submission to Reviewing Officer Name:

Designation:

REMARKS OF THE REVIEWING OFFICER / AUTHORITY

Signature of Reviewing Officer/Authority

Name :

Designation:

I have read this report.

Date: Signature of Officer reported upon.

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PART II – SECRET

(Not to be shown to the Officer reported upon)

(This part will not be the basis for promotion in the normal course)

1. Loyalty : (So as to Judge his suitability for assignment to

Sensitive Posts)

Has anything come to your knowledge which reflects adversely Yes ( ) No ( )

on the Officer’s loyalty

If ‘Yes’ please give details

(Add separate sheets if necessary)

2. Integrity and General Reputation:

(a) Has anything come to your knowledge either as oral or

written complaint or otherwise which reflects adversely

(i) On the Officer’s ability to honestly execute his duties Yes ( ) No ( )

(ii) Showing favoritism in discharging his duties Yes ( ) No ( )

If ‘Yes’ please give details of particulars

(b) (i) Has there been any preliminary finding regarding Yes ( ) No ( )
the corrupt practices of the Officer

(ii) Has any case of corruption on the Officer been Yes ( ) No ( )

referred to Vigilance Department, after preliminary
enquiries. If ‘Yes’ give details

3. Whether the Officer requires any training for the purpose of

his present job or for any higher responsibilities Yes ( ) No ( )

4. Whether the Officer should be posted to some other section/

office for better work or for other reasons (to be specified) Yes ( ) No ( )

Date: Signature of the Reporting Officer

Name:
Designation:
Date of submission to the Reviewing Officer

REMARKS OF THE REVIEWING OFFICER/AUTHORITY

Do you agree with the assessment made by the Reporting Officer Yes ( ) No ( )
If you wish to modify anything or add, please elaborate.

Signature of the Reviewing Officer/Authority

Date: Name:
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Designation:

INSTRUCTIONS

1. Performance Appraisal Form II (A) is meant for the category of Head Clerks, Junior Superintendents etc.
of Non-Secretariat Service.

2. The form will also be used for the personnel belonging to the above said categories working in other
Departments/Institutions on deputation, Foreign Service conditions, etc. and for ‘Non-gazetted’ Technical
Officers. When this is used for Non-gazetted Technical Officers the designations of the officers will be
type written at the top of the forms and against irrevalent columns, the words ‘not applicable’ will be
entered.

3. The forms consists of two parts viz. Part I and Part II. The facing sheets of Part I will be got filled up by
the reportee. A note on “Self Assessment” should be obtained from the reportee and filed as part of the
facing sheets. “Self Assessment” in this context means a brief resume of work done by the Officer
reported upon during the period under report bringing out any special achievement of his/her during the
period, to be filed by the Officer reported upon. The resume should not exceed three hundred words. The
“Self Assessment” given by the reportee will help the Reporting Officer to make the ratings. The graphic
portion of Section A of Part I will be prepared by marking the appropriate grading items against the factors
given. Part I will be shown to the reportee and his signature obtained. Part II is meant for recording the
assessment of the Reporting/Reviewing Officer on the loyalty and integrity of the reportee. This part will
be considered as “Secret” and should not be shown to the reportee. This will not be a basis for determining
the Officer’s suitability for promotion/appointment to higher posts.

4. Special care should be taken in filling up the Performance Appraisal Forms by the Reporting and
Reviewing Officer.

5. The ratings should be done taking into account the individual’s actual performance on the job during the
period under report.

6. The Reporting Officer should take special care to study the factors for appraisal and apply them
judiciously on the reportee’s performance. Normally, an impartial Officer can given only a few number of
“A” Grades to an Officer reported upon. Award of ‘A’ Grade should be substantiated.

7. The Reviewing Officer will record his remarks in a narrative form in the column provided in the form. If
he finds it necessary to revise the gradings given by the Reporting Officer he will do so, in which case the
gradings given by the Reviewing Authority will prevail.

8. It is the duty of Reporting Officers/Reviewing Officers to see that no item in the form is left unfilled.

9. In all other matters viz. disposal of representations received from the reportees, period of writing the
report, etc., and on matters not covered by these instructions, the procedure laid down in
G.O(P)No.344/PD dated: 22-08-1966 as amended from time to time will apply.